Probiotics and Prebiotics
Getting Friendly with Your Gut Bacteria ...
Probiotics, or the use of beneficial bacteria, are an exciting concept in the prevention and treatment of various childhood conditions. Definitive evidence on efficacy and safety is somewhat lacking, but there have been several good studies looking at probiotics like lactobacillus and active-culture yogurts in the prevention and treatment of diarrhea. The weight of the current evidence supports the use of probiotics in acute-onset childhood diarrhea, and their use with antibiotics to prevent antibiotic-associated diarrhea. In addition, the use of probiotic formulas (available in Europe for awhile, and now in the US) may reduce the number of diarrheal illnesses for children in day-care settings. Some small studies suggest that probiotics may also help prevent colds, colic, thrush, yeasty diaper rashes, non-specific tummy aches, and urinary tract infections.
What's especially interesting is the idea that establishing a healthy gut bacterial ecosystem early in infancy may steer the development of the immune system away from hyper-reactive "atopic" conditions like eczema, asthma, and seasonal allergies; this could be very useful in families where there's a family history of these conditions. The research here is early and somewhat conflicting, but this is an area to watch.
The bacteria that colonize your intestines set up shop early on, and the bacteria found in hospital environments don't seem to be the healthiest to be colonized with. It may prove to be wise for pregnant women to consume active-culture yogurt, kefir, or probiotics, and to supplement babies with these healthy bacteria. It should be emphasized that the research on this topic is in its infancy, and that definitive safety and efficacy information is not available. Furthermore, research has not defined what strains of probiotics work best (or at all!) for various conditions. But so far, we have not seen serious side effects except in significantly immuno-suppressed children.
As far as yogurts are concerned, not all are created equal. In kids from 8mo-2yo and in malnourished adoptees, full fat is the way to go. Stonyfield Organic Yogurts (they make "YoBaby") are well-regarded, tasty, all natural, and have 6 kinds of friendly bacteria, as well as prebiotics (see below). For promotion and maintenance of healthy gut bacteria, serving yogurt daily is a safe, time-tested, granny-approved, and easy-to-find way to go. But for treatment purposes or early in infancy, you might consider probiotic supplements, which can deliver many more of these healthy bacteria than a container of yogurt.
Like any unregulated "nutriceutical", it can be hard to find reliable, standardized products, and even harder to get them covered by your insurance. Probiotics, in particular, do not always contain healthy, viable strains of bacteria. One excellent brand of probiotic supplements that's available locally in Seattle is the Pharmax HLC line. Pharmax is involved in a major trial of infant probiotic supplementation, uses human rather than cattle or soil strains, and guarantees high potency. This line is carried at Clark's Pharmacy in Bellevue (425-881-0222), Bastyr Dispensary in Wallingford (206-834-4114), Pharmaca in Madison Valley (206-789-0800), Medicine Man Drugstore in Greenwood (206-789-0800), and online at various resellers.
Pharmax makes an infant powder (HLC Neonate) that's specially formulated for babies, and is easy to give. They also make "toddler straws", where the probiotic is actually inside a straw - nifty, convenient, but not cheap. Their most cost-effective option for children is HLC High Potency Powder, using 1/2 tsp daily for "treatment" dose, and 1/4 tsp daily for "maintenance" dosing. They also just came out with HLC Mindlinx, with additional strains designed to digest casein and gluten, for folks with sensitivites to those, or children with autism that have responded to elimination diets (major unproven claims/controversial issue alert ... but interesting as an example of more targetted probiotic therapy).
Culturelle supplements use Lactobacillus GG, one of the most studied strains, and are easy to find over-the-counter in most drugstores. Lactinex packets are available by prescription in some pharmacies. Nature's Way is another easy-to-find brand that sells a blend of probiotic strains, included lactobacillus reuteri, which was used in the recent infant colic study. The actual Biogaia drops used in that study are not sold here, but the manufacturer does have a US order page.
You'll also want to think about prebiotics - foods and supplements that help these healthy bacteria thrive. These can be found naturally in breast milk, honey (not for use <1yo), garlic, onions, leeks, wheat, bananas, asparagus, artichokes, and chicory root. Supplements of fructo-oligosaccharides (FOS) are also available, and Pharmax includes them in many of their probiotic formulations.
What's fun about this topic from the adoption medicine perspective is that the Eastern European docs love probiotics. "Dysbacteriosis" is a frequently seen diagnosis, often treated with "ferments and enzymes", and while you'll still want to rule out parasites like giardia and other malabsoptive causes of funny poops, I am convinced that children raised in hospitals and institutions have less healthy gut bacteria. In Russia, you can even get yogurt fortified with the power of Cosmonaut intestinal bacteria! Cosmonauts being the pinnacle of Russian health and fortitude, I suppose. Best not to think about how they collect said bacteria ...
Probiotics Resources:
- Fast Facts about Yogurt and Beneficial Bacteria - DrGreene
- Surprising Uses and Benefits of Yogurt - DrGreene
- Full Fat Yogurt for Infants and Toddlers - DrGreene
- Should You Feed "Friendly Bacteria" to Your Infant and Child? - Dr. Parker
- The Probiotics Web Page
Updated 7/07
Jun 30, 2005
Reader Comments (1)
I like your "unproven claims alert" that notified me that while the claim has not gone through the scientific proof gauntlet, it still merited mentioning, and would be probably be harmless to try without waiting for the jury to come in.
I found Dr. Green's collection of facts and observations eye opening to say the least. His conclusion, "Bad news captures the headlines while truly powerful good news is often slower and less obvious. The same is true for bacteria." http://www.drgreene.com/21_688.html. This statement rings true, and resonates with the value of proper hydration for health, see http://www.watercure.com/ for more. The simple and basic are so often overlooked.
His conclusion in the next article, "If antibiotics are important to give, choose the most narrow-spectrum option that would work (antibiotics that kill the desired bacteria, and as few of the bystander bacteria as practical). Whenever a child needs antibiotics, I suggest also giving probiotics to replenish the diversity of beneficial bacteria." http://www.drgreene.com/21_1697.html. This suggests an intelligent coexistence of allopathic and more traditional nature based medicine. I took probiotic supplements after getting an antibiotic shot to cover a nasty cat scratch, but I didn't even know there were "narrow-spectrum options" available, fantastic to know this now.
Your post has opened the door for not only the potential use of probiotics with our future adopted child, but using it to cultivate our own optimal health as well. And, for taking advantage of the power of, while minimizing some of the unintended side effects of allopathic medicine.
Thank you.